Thursday, February 14, 2013

My Diagnosis of Medicine: Imprecise

“Everyone
is different.” We joke about it now. But it is the summary of my wife’s and my
own frustrations with modern medicine.

We anticipate
hearing that line in doctors’ offices now. We can finish a doctor’s sentence
when we ask a question to get at some level of certainty about my wife’s
current medical status, reaction to treatment, or future prognosis.

They just
don’t know. They, in their impressive white coats and framed medical degrees,
can’t give a definitive and precise answer.

I don’t
really blame them, now that I’m more intimately aware of medical research and
treatment related to my wife’s fight with cancer. But previously, without this
experience, I had a notion that medicine was a field of scientific precision. I
thought that when you ask a question of a medical doctor, after submitting
yourself to a series of invasive and high tech tests, that you could get a very
clear and specific answer.

You don’t
always get that.

You do get
a lot of qualified answers, full of soft words like “might” and “maybe” and
“could” and “hopefully.” Then, when you ask why you don’t get more of a solid
answer, you get....wait for it.... “well, everyone is different.”

That means
the human body is not a machine. All our moving parts vary from one person to
another. For all the medical research, for all the rigor of scientific process,
it is still not possible to say that if you take this pill, have this
procedure, adopt this diet or whatever, that you will be cured without
question, 100 percent.

I also am a
doctor, although not a medical doctor. As a PhD working as a professor in a
field known as social science versus medical science, I study human behavior,
which is more dependent on variables like attitude, value, social structure and
so on. In social science, we would consider it preposterous to predict that 100
percent of a certain class of people will change their mind or act a certain
way based on a certain circumstance. Instead, we look at percent response,
variation in response, and multiple causes to the studied effect.

But I had
thought that in science, what we call hard or physical science, there would be
more straightforward relationships. But only in certain areas of study can things
be predicted with absolute certainty, in what we call not theories but laws.
The law of gravity in physics is an example. But I was naïve to assume that
such laws governed medicine.

This
reality bears itself out in multiple ways. Not all doctors agree. Articles come
out that contradict long-held understandings of medical causes and treatments.
Patients have to weigh the risk versus benefit of treatments, and whether the
side effects of a treatment are worse than what they are supposed to be curing.
This is another case where “everyone is different.”

One thing
we have noticed in all of this is the importance of the softer skills in the
middle of medicine. The skills and concepts taught in my field of public
relations and communications, and its specific application in the field of
health communications, for example, is what really sets apart doctors’ offices.
Their staffs, from the receptionist to the nurses and physician’s assistants, and
sometimes the doctors themselves, are the real difference makers.

We have
been in situations where the two extremes of health care communication have
been in evidence. In some, my wife has felt like a number, asked to fill out
information for the hundredth time that they should already have in their
system. Repeating her birth date so the medical professionals know they are
talking to the right person. We have had to remind them that something quite
important needed to happen in the RIGHT side, not the left. They seem annoyed
when we ask questions, expecting us to be like lambs and submit to their care,
in spite of the lack of precision and our experience with mistakes. I,
meanwhile, have been all but ignored as someone who is not a patient and
somehow, even though I am going through all of this too. This is why my wife
introduces me as Dr. Tim Penning.

In other
medical offices, the staff smiles when we enter and greet both of us by name.
They remember that my wife likes to be greeted by her short name or nickname,
and not her full given name. My wife has fond nicknames and inside jokes with
some of these people. They remember aspects of her life and personality and ask
about them. They even remember me and greet me by name. They spend ample time
answering questions and putting us at ease.

In this
context, even thought the medical science may be imprecise, at least we have a
level of comfort and camaraderie to make up for the lack of certainty. I thank
God for doctors and medical professionals who work hard and are continually
making progress to understand and fight disease. But I have come to be
especially grateful for those in medicine who see each patient uniquely, with
unique diagnoses, personalities, life situations, concerns and faith
perspectives. They see patients as fellow humans, not as medical cases. That’s why
such people are making a difference: they are responding appropriately to the
fact that “everyone is different.”